Interpretation of lab results

Lab Normal value Comments Albumin 3.5 - 5.0 g/dl Decreased: cystic fibrosis, chronic glomerulonephritis, alcoholic cirrhosis, Hodkin's disease, malnutrition, nephrotic syndrome, multiple myeloma, inflammatory bowel disease, leukemia, collagen-vascular diseases Aldosterone upright: 4-31 ng/dl Increased: hyperaldosterism (primary or secondary). Decreased: adrenal insufficiency, panhypopituitarism. Amylase 30-100 U/liter Increased: acute pancreatitis, pancreatic duct obstruction, alcohol ingestion, mumps, parotitidis, renal disease, cholecystitis, peptic ulcers, intestinal obstruction, mesenteric thrombosis, postop abdominal surgery.  Decreased: Liver damage, pancreatic destruction (pancreatitis, cystic fibrosis) Bilirubin Total: 0.2 - 1.2 mg/dl; direct: <0.3 mg/dl Increased total: hepatic damage (hepatitis, toxins, cirrhosis), biliary obstruction, hemolysis, fasting. Increased direct (conjugated): biliary obstruction / cholestasis, drug induced cholestasis. BUN 7-20 mg/dl Increased: renal failure, pre-renal azotemia, shock, volume depletion, postrenal (obstruction), GI bleeding, stress, drugs (aminoglycosides, vanco etc).   Decreased: starvation, liver failure, pregnancy, infancy, nephrotic syndrome, overhydration. Calcium 8.8 - 10.3 mg/dl Increased: primary hyperthyroidism, parathyroid hormone secreting tumors, vitamin D excess, metastatic bone tumors, chronic renal failure, milk-alkali syndrome, osteoporosis, thiazide drugs, pagets disease, multiple myeloma, sarcoidosis. Decreased: hypoparathyroidism, insufficient vitamin D, hypomagnesemia, renal tubular acidosis, hypoalbuminemia, chronic renal failure (phosphate retention), acute pancreatitis C02 (total) 23-30 meq/l Increased: respiratory acidosis, compensation for metabolic acidosis, severe vomiting, primary aldosteronism, volume contraction, emphysema Decreased: Respiratory alkalosis, starvation, DKA, lactic acidosis, alcoholic ketoacidosis, severe diarrhea, renal failure, drugs (salicylates etc), dehydration. Chloride 95-107 meq/l Increased: diarrhea, renal tubular acidosis, mineralocorticoid deficiency, hyperalimentation, medications (acetazolamide, ammonium chloride). Decreased: mineralocorticoid excess, vomiting, diabetes mellitus with ketoacidosis Creatinine 0.5 - 1.4 mg/dl Increased: renal failure including prerenal, drug-induced (aminoglycosides, vancomycin, others), acromegaly.  Decreased: loss of muscle mass, pregnancy. Ferritin 13 - 300 ng/ml Decreased: iron deficiency anemia (earliest sign) Iron binding capacity (TIBC) 250-420 mcg/dl Increased: acute and chronic blood loss, iron deficiency anemia, hepatitis, oral contraceptives.  Decreased: anemia of infection and chronic diseases, cirrhosis, nephrosis, hemochromatosis Magnesium 1.6 - 2.6 mg/dl Increased: renal failure, hypothyroidism, severe dehydration, lithium intoxication, antacids, Addison's disease.   Decreased:  hyperthyroidism, aldosteronism, diuretics, malabsorption, hyperalimentation, nasogastric suctioning, chronic dialysis, renal tubular acidosis, drugs (aminoglycosides, cisplatin, ampho B), hungry bone syndrome, hypophosphatemia, intracellular shifts with respiratory or metabolic acidosis. Osmolality 278 - 298 mOsm/kg Increased: hypernatremia, hyperglycemia, water loss (diuretics, diabetes..), alcohol ingestion, ethylene glycol ingestion, mannitol.  Decreased: hyponatremia, diuretics, Addison's disease, SIADH. Phosphorus 2.5 - 4.5 mg/dl Increased: hypoparathyroidism, excess vitamin D, secondary hyperparathyroidism, renal failure, bone disease, addisons disease.   Decreased: hyperparathyroidism, alcoholism, diabetes, hyperalimentation, acidosis, hypomagnesemia, diuretics, vitamin D deficiency, phosphate-binding antacids. Transferrin 200-400 mg/dl Increased: iron deficiency anemia.  Decreased: acute and chronic inflammatory states, poor nutritional status, chronic liver disease. Uric acid Male: 3 - 8 mg/dl.  female: 2-7 mg/dl Increased: gout, renal failure, drugs (diuretics, others), hypothyroidism, chemotherapy, parathyroid diseases, lactic acidosis.   Decreased: drugs (allopurinol, probenecid, others), Wilson's disease, Fanconi's syndrome.